How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,621.81 | Professional | None | $562.34 | $691.83 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,584.89 | Professional | None | $537.03 | $831.76 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $2,691.53 | Facility | None | $575.44 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $2,344.23 | Professional | None | $660.69 | $1,047.13 | $2,344.23 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,511.89 | Professional | None | $758.58 | $1,288.25 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,995.26 | Professional | None | $724.44 | $1,047.13 | $1,995.26 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $331.13 Typical High $389.05 | Professional | 52 · Reduced service | $281.84 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $131.83 Typical High $158.49 | Professional | 53 · Discontinued | $112.20 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $85.11 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $549.54 |
Where New Hampshire sits
The same service costs 4.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Hampshire· 13th of 51
$1,000
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.